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Ocrevus (ocrelizumab)

Ocrevus ™ is a CD20-directed cytolytic antibody indicated for the treatment of patients with relapsing or primary progressive forms of multiple sclerosis (MS). It is a disease-modifying drug (DMD) made from monoclonal antibodies (proteins). Ocrevus is administered by intravenous (IV) infusion in a medical setting.

What are the ingredients in Ocrevus?

The active ingredient in Ocrevus is ocrelizumab.

How does Ocrevus work?

The way Ocrevus works in MS is not fully understood. The drug binds to CD-20, a cell surface antigen on immune system B-cells, which may be involved in the processes that cause brain damage in MS.

What are the possible side effects of Ocrevus?

Many clinical trials evaluated the safety and efficacy of Ocrevus. The most common side effects experienced by those taking Ocrevus include:

  • Upper respiratory tract infections
  • Infusion reactions
  • Skin reactions or infections
  • Throat irritation, swelling or difficulty breathing
  • Cough
  • Diarrhea or vomiting
  • Herpes virus associated infections
  • Increased risk of developing malignancies (cancer)
  • Fever, fatigue or headache

Reactions can happen for up to 24 hours after your infusion. Over-the-counter pain relief medications can be used to minimize symptoms of infusion reactions.

This is not an exhaustive list of all potential side effects of Ocrevus. For more information, consult your doctor or healthcare provider. If you notice any new or worsening side effects when taking Ocrevus, contact your doctor or healthcare provider immediately.

Things to note about Ocrevus

Ocrevus comes as a sterile, clear or slightly opalescent, and colorless to pale brown solution in a single-dose vial. It must be prepared by a healthcare professional to create the proper drug concentration in an infusion solution. Prior to the start of the treatment, the contents of the infusion bag should be at room temperature. Solutions are visually inspected for particulate matter and discoloration prior to administration. It cannot be used if discolored or contains particulate matter. The prepared infusion solution should be used immediately or stored for up to 24 hours in the refrigerator; or 8 hours at room temperature including time for infusions. If the solution is not used within that time frame or the same day, the solution should be discarded.

Ocrevus may be impacted by other medications; as well as affect the way other medications work. This especially may apply to immune-modulating or immunosuppressive therapies. Your doctor will be able to tell you if any medications you are currently taking fall into these categories, or if they might impact your treatment with Ocrevus.

Prior to initiating treatment with Ocrevus all patients should undergo Hepatitis B virus (HBV) screening. Ocrevus is contraindicated for people with an active Hepatitis B virus or any active infection.

Before each successive infusion patients should be pre-medicated with 100 mg of methylprednisolone or an equivalent corticosteroid administered intravenously approximately 30 minutes prior to each Ocrevus infusion. This will reduce the frequency and severity of infusion reactions. Additional pre-medication with an antihistamine (e.g., diphenhydramine) approximately 30-60 minutes prior to each infusion can further reduce the frequency and severity of infusion reactions.

Before starting Ocrevus, talk with your doctor if you:

  • Have an active Hepatitis B virus infection
  • Have a history of hypersensitivity to or life threatening reaction to Ocrevus
  • Have had vaccines within 6 weeks of initiating Ocrevus therapy
  • Have an active infection
  • Are pregnant or planning to get pregnant, as there is limited information on the use of Ocrevus in pregnancy or in nursing mothers

Individuals with the above conditions should be monitored closely while taking Ocrevus.

Dosing information

The initial dose of Ocrevus is 300 mg intravenous infusion, followed two weeks later by a second 300 mg infusion. Subsequent doses of 600 mg intravenous infusion are administered every 6 months. 300 mg dosages are infused over a period of 2 ½ hours; 600 mg doses take 3 ½ hours.

Patients should be observed for at least one hour after the completion of each infusion.

If a planned infusion is missed, it should be rescheduled and administered as soon as possible; you should not wait until the next scheduled dose. Reset the dose schedule to administer the next sequential dose 6 months after the missed dose is administered. Doses of Ocrevus must be separated by at least 5 months.

Pain and fever-reducing medication can be taken to help reduce any flu-like symptoms.

For more information, read the full prescribing information of Ocrevus.

Written by: Linda Minton | Last reviewed: July 2019.
  1. “Now approved: Ocrevus for relapsing or primary progressive forms of multiple sclerosis.” March 2017. Available from:
  2. Ocrevus Prescribing Information. Genentech, Inc. Mar 2017. Available from: